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Alzheimer’s and mHealth: Regulatory, Privacy and Ethical Considerations
Published in Christopher M. Hayre, Dave J. Muller, Marcia J. Scherer, Everyday Technologies in Healthcare, 2019
Bonnie Kaplan, Sofia Ranchordás
By early 2018, over 318,000 mHealth apps were available for download, up from more than 100,000 health apps reported in 2015 (Byambasuren et al. 2018, Xu and Liu 2015). mHealth applications support a broad array of healthcare services by providing customised diagnosis, disease management and monitoring and lifestyle or well-being advice. They are expected to make the doctor–patient relationship more cooperative, help patients save money, revolutionise physical examinations, improve mental states, give patients more control over their medical decisions and disease management, assume some of clinicians’ jobs and responsibilities, improve outcomes and access to healthcare services, decentralise and democratise medicine, reduce healthcare spending and ‘level the playing field in patients’ favor … Ultimately chang[ing] the future of healthcare forever’ (Byambasuren et al. 2018, YML Media Labs 2018). mHealth applications are praised for promoting health by providing real-time feedback to users, motivating users to change unhealthy lifestyle habits and facilitating the use of medical devices to monitor health conditions (World Health Organization 2011). mHealth also helps patients overcome the stigma of seeking some healthcare services, such as mental healthcare (Gard 2012, Lopez and Patten 2013, Price et al. 2014). mHealth, like the broader category of eHealth, is promoted as improving services and access to healthcare providers (including specialty services) through consultation, communication with patients and intervention (McCubbin 2006); reducing disparities in healthcare accessibility; decreasing travel time for both patient and clinician and empowering patients. These expected benefits also could lead to changes in infrastructure that would provide seamless and continuous care available on a more equitable basis by allowing inter-organisational cooperation and the ready flow of information between patients and providers, wherever located (Kaplan and Litewka 2008).
Should Human Rights and Autonomy be The Primary Determinants for the Disclosure of a Decision to Withhold Futile Resuscitation?
Published in The New Bioethics, 2019
The doctor–patient relationship depends on trust and good communication. Patients are diverse: they have different values, different expectations and different ways of coping with illness. End-of-life discussions come at what can be a highly emotional time and patients may be feeling ill and vulnerable. Full disclosure about resuscitation status may be an expression of one person’s autonomy. For others, it may force discussions that they would prefer not to have: overriding their autonomy. It is difficult to legislate to please all.